Impact of thrombus aspiration during primary percutaneous coronary intervention in cardiogenic shock complicating ST-segment elevation myocardial infarction

Aim: To assess the impact on in-hospital and long-term survival of thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Methods and Results: From September 2001 to May 2010 we collected data from 155 patients affected with STEMI complicated by CS undergoing PPCI (12.4% of all PPCI) including 70 patients (45.2%) in TA group and 85 patients (54.8%) in conventional PCI group. Patients in TA group were more likely to have right ventricular infarction (24.3% vs 5.9%, p = 0.002), higher mean left ventricular ejection fraction (40% +/- 9% vs 35% +/- 7%, p < 0.0001) and lower left main coronary artery occlusion (2.8% vs 21.2%, p = 0.002). TA was associated with a lower rate of in-hospital and long-term mortality (31.4% vs 48.2%, p = 0.05 and 42.8% vs 64.7%, p = 0.01 respectively) at a mean follow-up time of 6.1 +/- 2.1 years. At multivariate analysis the only independent predictor of in-hospital and long-term survival was the procedural success (HR 0.18 95% CI 0.025-0.31, p = 0.03 and HR 0.46 95% CI 0.09-0.74, p = 0.034 respectively). Conclusions: In this retrospective study TA, performed during PPCI for STEMI complicated by CS, was not an independent predictor of in-hospital and long-term survival. (C) 2013 Elsevier Inc. All rights reserved.